December 2010

November 2010

FUNDED Articles

At this time in 2012, it was pretty clear that CMS was not thrilled with the process of, or response to, the Health Care Innovation Challenge, and it would ultimately be a one-and-done funding opportunity. However, if you were paying close attention during the first round, the messaging from CMS has been anything but consistent.

As would-be applicants to the Health Care Innovation Challenge across the country are learning, the Center for Medicare & Medicaid Services' monstrous $1 billion program aimed at innovating health care and payment models in an effort to save money is no walk in the park.
By December 19, 2011, CMS had received well over 10,000 letters of intent for the program. While a significant percentage of these LOIs will probably not result in full proposal submissions, interest in the program has been unsurprisingly overwhelming. With the January 27 deadline looming, project developers, writers, and other grants professionals are knee-deep in the murky program requirements, which call for a tightly-knit forty-page narrative and a complex total cost of care savings plan, among other elements.

The health sector grant funding landscape is abuzz with excitement. The new Health Care Innovation Challenge program is providing $1 billion in funding for projects that offer innovations in service delivery and payment modeling. The primary target population for the funding are those individuals enrolled in CMS insurance programs, which includes Medicare, Medicaid, and Child Health Insurance Program (CHIP). While applicants can address other populations, the project will not be funded unless one of the three CMS-insured populations are incorporated at some level.

When the Health Resources and Services Administration (HRSA) announced major changes in their upcoming slate of well-known nursing education programs for Fiscal Year 2012, many people started to panic . One change in particular, inter-professional education, which is being emphasized across all of their programs, has received mixed reviews. While the academic jury is still out on the effectiveness of inter-professional education methodologies compared to traditional nursing programs, HRSA has went all-in on supporting such models. For instance, the Nurse Education, Practice, Quality and Retention Program (NEPQR) will fund three-year demonstration projects in inter-professional education in the context of advancing the diverse priorities applicants are able to target historically under the program. In the past, HRSA funding under this program was limited to educating nursing personnel exclusively.

Congratulations! You put together a competitive proposal under BTOP and were fortunate enough to be funded. Now you are in a position to provide broadband to all these previously underserved communities. There's just one problem: The community anchor institutions (CAIs) in your area do not have the financial resources to implement their broadband-intensive projects. Fortunately, grant programs are available for CAIs to fund their initiatives, which can have a direct impact in increasing demand for broadband infrastructure.

With Healthcare, one thing you can count on for certain is that it typically trails other industries by at least a decade in terms of the latest trends. While other sectors started moving away from file cabinets and towards electronic records in the early 1990s, the health industry is just starting to see significant uptake of electronic health records. However, it seems that many healthcare organizations are intent on following the latest trends towards utilization of mobile electronic devices, or mHealth. Indeed, many health care organizations are utilizing custom mobile applications to turn smart phones and other devices into personal health assistants.

There are all kinds of disasters that require emergency response. Some of them occur naturally like pandemic influenza and hurricanes. Others are man-made disasters such as exploding bombs and other terrorist attacks. No matter the cause, health care providers play an essential role in the aftermath of these events, caring for the sick and wounded. In addition, health care entities play a major role in preventing certain catastrophes like the spread of infectious diseases. States and other regulatory agencies require hospitals and other health care organizations to be prepared for and able to respond to such emergencies.

In the health sector, money continues to flow from the Prevention and Public Health Fund (PPHF), originally created in the health reform legislation passed in FY 2010 (Patient Protection and Affordable Care Act). The PPHF was created in the same vein as its predecessor from the American Recovery and Reinvestment Act of 2009, the Prevention and Wellness Fund (PWF). However, while PWF represented a one-time appropriation with limited impact, the PPHF has real dollars committed to it for the next 10 years. In total, the PPHF represents a $15 billion investment over the next decade in community-wide efforts to prevent disease and manage chronic conditions by detecting and controlling them before they become severe and require costly interventions.

Anyone paying attention to the health sector grant funding landscape is certain to see several opportunities each year specifically designed for rural health networks. Under these programs, the Health Resources and Services Administration (HRSA) distributes the majority of federal dollars available to formally organized rural health networks, which usually requires a pre-existing relationship (prior to grant announcement), while some is reserved for entities in the planning stages of network development. In Fiscal Year 2012 alone, HRSA has committed $17.2 million in funding for rural health networks. Since most of the commitments are for multi-year projects, the real funding total over the next three years will exceed $50 million.

So you have checked a few items off your list: (1) You determined you are an eligible health care provider, (2) You have calculated an estimate incentive payment and realize what's at stake in terms of reimbursement, (3) You have begun the registration process with CMS (Medicare) or the agency in your state administering the Medicaid program, and (4) You have reviewed and completely understand the various objectives and measures that your EHR system must meet in order to prove meaningful use and capitalize on the incentives.

So you have checked a few items off your list: (1) You determined you are an eligible health care provider, (2) You have calculated an estimate incentive payment and realize what's at stake in terms of reimbursement, (3) You have begun the registration process with CMS (Medicare) or the agency in your state administering the Medicaid program, and (4) You purchased an EHR system that is certified by the Office of the National Coordinator Authorized and Testing Certification Body.

Unless you have been hibernating in a cave for the past year, everyone connected to healthcare has been hearing the buzz words - Certified EHR Technology, Incentives, and Meaningful Use. The Medicare and Medicaid EHR Incentives were included in the American Recovery and Reinvestment Act of 2009, but registration just recently opened as payments will be dished out for the first time in 2011. Almost $20 billion is available to encourage the adoption of electronic health care records by health care providers across the United States.

The biggest news for the health sector funding landscape came in the form of the election results from November. The fact that the Republicans gained control of the House of Representatives (House) has fueled speculation that the health reform package that was passed earlier this year may be repealed. The health reform legislation, which is known as the Patient Protection and Affordable Care Act (PPACA), included appropriations for several demonstration projects and grant programs that are scheduled to open over the next several fiscal years. While the exact dollar amount is unknown, it is estimated that the total amount available through PPACA grants will reach ten figures. Many of the Republicans that came to office as part of the TEA Party (Taxed Enough Already) movement ran on a platform of repealing PPACA.

HHS recently announced over $390 million in federal funding for the Hospital Preparedness Program. This is federal funding that passes through state health departments to health care providers. Fiscal year 2010 is the first year that the federal government is requiring a 10% match on federal funds. In other words, states and local providers must commit at least $1 for every $10 in federal contributions.

If you are paying close attention to the health care funding landscape, a new phrase and abbreviation has entered the grants lexicon. Many opportunities being released by the U.S. Department of Health and Human Services (HHS) are being prefaced with "Affordable Care Act" or "ACA". Apparently, this is the consensus designation for grants authorized through the health reform legislation, or the Patient Protection and Affordable Care Act that was signed into law on March 23, 2010. The ACA has authorized several grant programs over the next decade to address workforce development and professional shortages in the health arena, improve health care quality overall, and fund the deployment of comprehensive care management delivery models.

In the health care arena, it would be inaccurate to claim that the funding realm has fully shifted to the "life after the recovery act" phase. After all, ARRA funds continue to flow through grant programs such as Communities Putting Prevention to Work (CPPW). CPPW provides funding to local and state health departments in their efforts to promote prevention and wellness, particularly in the areas of smoking, obesity and physical fitness.